Nokea
A nurse is interviewing a distressed client, who relates being fired after 15 years of loyal employment. Which of the following questions would best assist the nurse to determine the clients appraisal of the situation? Select all that apply.
- A. What resources have you used previously in stressful situations?
- B. Have you ever experienced a similar stressful situation?
- C. Who do you think is to blame for this situation?
- D. Why do you think you were fired from your job?
Correct Answer: A
Rationale: The correct answer is A: "What resources have you used previously in stressful situations?" This question is the best choice as it focuses on understanding the client's coping mechanisms and resilience. By asking about previous resources used, the nurse can assess the client's strengths and support systems.
Choice B is incorrect because asking if the client has experienced a similar situation does not directly address the client's current appraisal of the situation.
Choice C is incorrect as it focuses on assigning blame, which may not be helpful in understanding the client's perspective and emotions.
Choice D is also incorrect because asking why the client thinks they were fired may lead to a defensive response and may not necessarily provide insight into the client's appraisal of the situation.
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A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
- A. Everyone diagnosed with OCD needs to control their ritualistic behaviors.
- B. It is important for you to discontinue these ritualistic behaviors.
- C. Why are you asking for help if you wont participate in unit therapy?
- D. Lets figure out a way for you to attend unit activities and still wash your hands.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the client's need to wash their hands due to OCD while also addressing the issue of missing unit activities. By suggesting finding a way for the client to attend activities while still accommodating their need to wash hands, it promotes a collaborative approach and respects the client's autonomy. Option A is incorrect as not everyone with OCD can completely control their behaviors. Option B is too directive and may increase resistance. Option C is confrontational and may discourage the client from seeking help.
A Native American client is admitted to an emergency department (ED) with an ulcerated toe secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which nursing intervention is most appropriate?
- A. Assist the client in contacting a shaman of his choice.
- B. Explain to the client that voodoo medicine will not heal the ulcerated toe.
- C. Ask the client to explain what the shaman can do that the physician cannot.
- D. Inform the client that refusing treatment is a clients right.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Cultural Competence: In respecting the client's cultural beliefs and practices, it is essential to honor the request for a shaman's presence.
2. Collaboration: By assisting the client in contacting a shaman, the nurse promotes collaboration between traditional healing methods and medical interventions.
3. Trust Building: Respecting the client's request fosters trust and rapport, which are crucial for effective communication and care.
4. Patient-Centered Care: This approach aligns with the principle of patient-centered care, where the client's preferences and values are prioritized.
Summary of Other Choices:
B: This choice is dismissive and disrespectful of the client's beliefs, potentially causing harm by undermining trust and rapport.
C: This choice puts the client on the defensive and does not address the immediate need for a shaman's presence.
D: This choice fails to address the client's request and focuses on the right to refuse treatment, which is not the immediate concern in
A client refuses to go on a cruise to the Bahamas with his spouse because of fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, the nurse should use which of these statements to explain to the spouse the etiology of this fear?
- A. Your spouse may be unable to resolve internal conflicts, which result in projected anxiety.
- B. Your spouse may be experiencing a distorted and unrealistic appraisal of the situation.
- C. Your spouse may have a genetic predisposition to overreacting to potential danger.
- D. Your spouse may have high levels of brain chemicals that may distort thinking.
Correct Answer: B
Rationale: The correct answer is B: Your spouse may be experiencing a distorted and unrealistic appraisal of the situation. This aligns with cognitive theory, which focuses on how our thoughts and perceptions influence our emotions and behaviors. In this case, the client's fear of the cruise ship sinking is likely based on an irrational and exaggerated belief rather than a realistic assessment of the situation.
Choice A is incorrect because it focuses on internal conflicts, which may not be directly related to the client's fear of the cruise ship sinking. Choice C is incorrect as genetic predisposition alone is unlikely to explain the specific fear of the cruise ship sinking. Choice D is incorrect as it suggests a biological basis for the fear, whereas cognitive theory emphasizes the role of thoughts and perceptions.
A nurse concludes that a restless, agitated client is manifesting a fight-or-flight response. The nurse should associate this response with which neurotransmitter?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
Correct Answer: C
Rationale: The correct answer is C, Norepinephrine. During the fight-or-flight response, the sympathetic nervous system is activated, leading to the release of norepinephrine. Norepinephrine increases heart rate, blood pressure, and alertness, preparing the body to either fight or flee from a perceived threat. Dopamine (A) is more related to reward and pleasure. Serotonin (B) is involved in regulating mood and emotions. Cortisol (D) is a stress hormone, not a neurotransmitter involved in the fight-or-flight response.
Which therapeutic communication technique is being used in this nurseclient interaction? Client: When I get angry, I get into a fistfight with my wife or I take it out on the kids. Nurse: I notice that you are smiling as you talk about this physical violence.
- A. Encouraging comparison
- B. Exploring
- C. Formulating a plan of action
- D. Making observations
Correct Answer: D
Rationale: The correct answer is D, Making observations. The nurse is objectively stating what they notice, which is the client smiling while discussing physical violence. This technique helps bring awareness to the client's behavior without judgment. Encouraging comparison (A) involves asking the client to compare similarities and differences, which is not present in this interaction. Exploring (B) involves delving deeper into the client's thoughts and feelings, which is not demonstrated here. Formulating a plan of action (C) involves working with the client to create a plan for addressing issues, which is not the focus of the nurse's statement.